Health and Financial Literacy and the Acquisition of COVID-19 Knowledge in Older Adults.

Knowledge about COVID-19 enters into many aspects of decision making, especially for older people who are at increased risk of severe disease or death. Yet little is known about the resources that supported older people's uptake of COVID-19 knowledge. Here, we hypothesized that higher pre-pandemic health and financial literacy was associated with higher COVID-19 knowledge. Participants were 434 community-based older people without dementia. COVID-19 knowledge was assessed via a 5-item measure, and health and financial literacy was assessed via a 32-item measure. In an ordinal regression model adjusted for age, gender, and education, higher literacy was associated with higher COVID-19 knowledge (p < .0001), and this association persisted after further adjusting for robust measures of global cognition or one of five specific cognitive domains (all p's ≤ .0001). These findings suggest that literacy plays a key role in supporting older people's acquisition of impactful knowledge in the real world.

Assessment of Key Factors Impacting Variability in AAV Vector Genome Titration by Digital PCR.

Recombinant adeno-associated virus (rAAV) has emerged as a prominent vector for in vivo gene therapy, owing to its distinct advantages. Accurate determination of the rAAV genome titer is crucial for ensuring the safe and effective administration of clinical doses. The evolution of the rAAV genome titer assay from quantitative PCR (qPCR) to digital PCR (dPCR) has enhanced accuracy and precision, yet practical challenges persist. This study systematically investigated the impact of various operational factors on genome titration in a single-factor manner, aiming to address potential sources of variability in the quantitative determination process. Our findings revealed that a pretreatment procedure without genome extraction exhibits superior precision compared with titration with genome extraction. Additionally, notable variations in titration results across different brands of dPCR instruments were documented, with relative standard deviation (RSD) reaching 23.47% for AAV5 and 11.57% for AAV8. Notably, optimal operations about DNase I digestion were identified; we thought treatment time exceeding 30 min was necessary, and there was no need for thermal inactivation after digestion. And we highlighted that thermal capsid disruption before serial dilution substantially affected AAV genome titers, causing a greater than ten-fold decrease. Conversely, this study found that additive components of dilution buffer are not significant contributors to titration variations. Furthermore, we found that repeated freeze-thaw cycles significantly compromised AAV genome titers. In conclusion, a comprehensive dPCR titration protocol, incorporating insights from these impact factors, was proposed and successfully tested across multiple serotypes of AAV. The results demonstrate acceptable variations, with the RSD consistently below 5.00% for all tested AAV samples. This study provides valuable insights to reduce variability and improve the reproducibility of AAV genome titration using dPCR.

Integrating transcriptomics and machine learning for immunotherapy assessment in colorectal cancer.

Colorectal cancer (CRC) is a highly prevalent and lethal malignancy worldwide. Although immunotherapy has substantially improved CRC outcomes, intolerance remains a major concern among most patients. Considering the pivotal role of the tumor microenvironment (TME) in tumor progression and treatment outcomes, profiling the TME at the transcriptomic level can provide novel insights for developing CRC treatment strategies. Seventy-seven TME-associated signatures were acquired from previous studies. To elucidate variations in prognosis, clinical features, genomic alterations, and responses to immunotherapy in CRC, we employed a non-negative matrix factorization algorithm to categorize 2595 CRC samples of 27 microarrays from the Gene Expression Omnibus database. Three machine learning techniques were employed to identify a signature specific to immunotherapy. Subsequently, the mechanisms by which this signature interacts with TME subtypes and immunotherapy were investigated. Our findings revealed five distinct TME subtypes (TMESs; TMES1-TMES5) in CRC, each exhibiting a unique pattern of immunotherapy response. TMES1, TMES4, and TMES5 had relatively inferior outcomes, TMES2 was associated with the poorest prognosis, and TMES3 had a superior outcome. Subsequent investigations revealed that activated dendritic cells could enhance the immunotherapy response rate, with their augmentation effect closely associated with the activation of CD8+T cells. We successfully classified CRC into five TMESs, each demonstrating varying response rates to immunotherapy. Notably, the application of machine learning to identify activated dendritic cells helped elucidate the underlying mechanisms contributing to these differences. We posit that these TMESs hold promising clinical implications for prognostic evaluation and guidance of immunotherapy strategies, thereby providing valuable insights to inform clinical decision-making.

Financial Risk Aversion Among Older Black and White Adults.

OBJECTIVES: Risk aversion has a substantial impact on decision making and is associated with key demographic characteristics. However, few studies have investigated whether risk aversion varies by race. METHODS: We investigated racial differences in financial risk aversion in 684 older Black and White adults without dementia in the Minority Aging Research Study and Rush Memory and Aging Project matched for age, education, sex, and cognition using Mahalanobis distance. We also investigated whether select contextual factors (self-reported discrimination, socioeconomic status, and literacy) mediated or affective factors (trust, loneliness, and neuroticism) moderated any observed racial differences. RESULTS: In regression models adjusted for age, education, sex, and cognitive function, older Black adults were more risk averse than older White adults (Beta = 0.1264, standard error = 0.0227, p value ≤ .00001). None of the contextual or affective factors mediated or moderated this association. DISCUSSION: Older Black adults are more financially risk averse than older White adults. Because risk aversion may be associated with important financial and health outcomes in older age, more research is needed to investigate the reasons for this difference.

Vulnerability of Older Adults to Government Impersonation Scams.

Importance: Financial fraud and scams targeting older adults are on the rise and pose serious public health and economic threats. Research on the vulnerability of older adults to fraud and scams relies almost exclusively on self-reported data, which have several intrinsic limitations. Thus, how older adults truly respond to fraud attempts remains unclear. Objective: To explore the vulnerability of older adults to a US government impersonation scam. Design, Setting, and Participants: This cross-sectional study, conducted from October to December 2021 among communities in the greater Chicago metropolitan area, was framed as a fictitious government agency reaching out to older adults about a potential compromise of personal information relevant to their Social Security and Medicare benefits. Participants were older adults participating in the Rush Memory and Aging Project, an ongoing cohort study of chronic conditions of aging. Data analysis was performed from February to August 2023. Exposures: Participants were exposed to deceptive materials through mailers, emails, and phone calls by a live agent. Main Outcomes and Measures: Based on the phone call data, participants were classified into 3 groups: no engagement (participants who did not answer the phone or call in), engagement (those who answered or called in but were skeptical about the legitimacy of the outreach and did not give away personal information), and conversion (participants who answered or called in without skepticism, or confirmed that they did not change their personal information, or provided the last 4 digits of their Social Security number). Results: A total of 644 older adults (501 [77.8%] female, 143 [22.2%] male), with a mean (SD) age of 85.6 (7.5) years, were included. A total of 441 (68.5%) participants did not engage, 97 (15.1%) engaged but raised skepticism, and 106 (16.4%) converted. Older adults who engaged but with skepticism had the highest cognition and financial literacy, while those in the conversion group had the lowest scam awareness. No differences were observed in psychological and other behavioral measures by the levels of engagement. Conclusions and Relevance: In this cross-sectional study using a behavioral experiment that mimicked a real-world imposter scam, a sizable number of older adults engaged without skepticism. Results suggest that many older adults, including those without cognitive impairment, are vulnerable to fraud and scams.

Multifunctional trade-off and compensation mechanism of arable land under the background of rural revitalization: a case study in the West Mountain Regions of Hubei Province.

Exploring the spatial relationship and ecological compensation mechanism of each function of arable land in poor mountainous areas is important to promote rural revitalization and enhance arable land protection. Taking the mountainous region of Western Hubei (MRWH) as an example, this study quantified the "three living" functions of arable land and its secondary functions. Using the root mean square deviation method to calculate the trade-off index, a quantitative method can more scientifically reflect the trade-off relationship between arable land functions and measure the overall ecological compensation. Studies have shown that (1) the value of the production function exhibits a growing and subsequently a falling trend, whereas the value of living function and ecological function exhibits an increasing trend over time, with an average functional value of 5310, 220 and 6496 million yuan, respectively. The spatial pattern of the "three living" functional values decreases from west to east. Among them, water conservation and soil conservation function values show a high distribution in the south and low in the north, gas purification and agricultural pollution functional values show a scattered spatial pattern, and the value of other functions shows an increasing trend from southeast to northwest; (2) among the primary functions, the trade-off between production and ecological functions is the strongest, decreasing, and then increasing over time, with an average trade-off index of 0.89. Among the secondary functions, there is the most obvious trade-off between the food supply function and the five ecological functions, which requires coordination; (3) overall, the total amount of ecological compensation has shown an upward trend, with priority areas for level I ecological compensation increasing year by year. Optimized compensation zones and potential compensation zones are concentrated in the northwest, ecological balance zones are located in the central part, and optimized development compensation zones and key development compensation zones are located in the southeast. According to the research, MRWH is oriented to ecological function, followed by the production function, supplemented by the living function. Green agriculture should be vigorously developed and ecological function space should be compressed by strictly limiting the excessive expansion of production activities. Promoting the improvement of production function through ecological function, while exploring the potential value of living function. Ecological compensation in strict accordance with the priority of ecological compensation, zoning. Realizing cross-regional cooperation, low compensation areas drive high compensation areas to achieve sustainable development of arable land.

The Relationship of MRI-Derived Alzheimer's and Cerebrovascular-Related Signatures With Level of and Change in Health and Financial Literacy.

OBJECTIVE: The cortical thickness "signature" of Alzheimer's disease (AD-CT) and white matter hyperintensity (WMH) burden have each been associated with cognitive aging and incident AD and related dementias. Less is known about how these structural neuroimaging markers associate with other critical behaviors. We investigated associations of AD-CT and WMH volumes with a composite index of health and financial literacy given that the ability to access, understand, and utilize health and financial information significantly influences older adults' health outcomes. DESIGN, SETTING, PARTICIPANTS: Participants were 303 adults without dementia (age∼80 years; 74% women) from the Rush Memory and Aging Project. MEASUREMENTS: Baseline 3T MRI T1-weighted structural and T2-weighted FLAIR data were used to assess AD-CT and WMH volumes, respectively. Literacy was measured using questions designed to assess comprehension of health and financial information and concepts, yielding a total literacy score. Multivariable linear mixed effects regression models determined the relationship of each neuroimaging marker, first separately and then combined, with the level of and change in literacy. RESULTS: Reduced AD-CT and higher WMH at baseline were each associated with lower levels of literacy; only AD-CT was associated with the rate of decline in literacy over time. The association of AD-CT with change in literacy persisted when both neuroimaging markers were included in the same model. CONCLUSIONS: The cortical thickness signature of AD predicts changes in health and financial literacy in nondemented older adults suggesting that the multidimensional construct of health and financial literacy relies on specific brain networks implicated in AD.

Financial development-green growth nexus in China: the role of technological capital.

It is undeniable fact that financial development and technological capital are fundamental determinants that help in the achievement of green growth. This is important to explore the nexus between financial development, technological capital, and green growth in China. This study utilizes the quantile autoregressive distributed lag (QARDL) approach for exploring the effect of financial development and technological capital on green growth. The study measures financial development through financial market development and financial institutions development. The study concludes that technological progress and both measures of financial development produce a positive impact on green growth in China in most quantities in long run. The study provides various important policy suggestions that help in upgrading sustainable green growth in China.

Well-Being and Aging-Related Decline in Financial and Health Literacy in Advanced Age.

OBJECTIVES: Emerging evidence suggests that financial and health literacy deteriorates in advanced age. By contrast, well-being promotes health in aging. This study tested the hypothesis that well-being is associated with slower aging-related literacy decline. METHODS: Participants were 1,099 community-based older adults without dementia at baseline. Financial and health literacy was assessed at baseline and annually thereafter via a 32-item measure. Well-being was assessed at baseline via the 18-item version of Ryff's Scales of Psychological Well-Being. RESULTS: During up to 12 years of annual follow-up, literacy declined about 1 percentage point per year on average (ß = -0.91, standard error [SE] = 0.08, p < .001); however, there was considerable variation in change in literacy between participants (random slopes variance = 1.24, SE = 0.15, p < .001). In a linear mixed-effects model adjusted for age, sex, and education, higher well-being was associated with higher starting level of literacy (ß = 2.31, SE = 0.67, p = .001) and, critically, slower literacy decline (ß = 0.29, SE = 0.11, p = .01). The association of higher well-being with slower literacy decline persisted in models that additionally adjusted for income, medical conditions, depressive symptoms, and a robust measure of global cognition. DISCUSSION: This study suggests that well-being helps stave off aging-related literacy decline.

Psychological Well-being Relates to Healthcare and Financial Decision Making in a Study of Predominantly White Older Adults.

The purpose of this study was to test the hypotheses that psychological well-being is associated with healthcare and financial decision making in older adults and that this association varies by the level of cognitive function. Participants were 1082 older adults (97% non-Latino White; 76% women; mean age = 81.04 years; SD = 7.53) without dementia (median MMSE score = 29.00, IQR = 27.86-30.00). In a regression model adjusted for age, gender, and years of education, higher levels of psychological well-being were associated with better decision making (estimate = 0.39, standard error [SE] = 0.11, p < .001), as was better cognitive function (estimate = 2.37, SE = 0.14, p < .0001). In an additional model, an interaction of psychological well-being and cognitive function was significant (estimate = -0.68, SE = 0.20, p < .001), such that higher levels of psychological well-being were most beneficial for decision making among participants with lower levels of cognitive function. Higher levels of psychological well-being may help sustain decision making among older persons, particularly those with lower levels of cognitive function.

Green growth and environmental sustainability in China: the role of environmental taxes.

This study aims to investigate the impact of environmental-related taxes on green growth and CO2 emissions in China covering the time 1996-2019. To get the short- and long-run estimates, we have applied the bounds testing approach. Estimates of the study provide some important results. In the short run, environmental taxes and environmental policy stringency estimates are negatively significant in the CO2 emissions models and positively significant in the green growth models. Likewise, the long-run estimates attached to environmental taxes are significantly negative in the basic and robust CO2 emissions models while insignificant in the green growth models. However, the long-run estimates of environmental policy stringency are significantly negative in the basic and robust CO2 emissions models and significantly positive in the basic and robust green growth models. In general, our findings imply that an increase in environment-related taxes and strictness in environmental policies help reduce CO2 emissions and promote green growth in China.

Determinants of China's renewable energy industry development: do eco-innovation and financial inclusion matter?

Fossil fuels are causing irreparable damage to the environment and lead to the depletion of reservoirs of coal, oil, and gas, which may give rise to the issue of energy scarcity and security. Therefore, policymakers and empirics have looked for alternative sources of energy that are affordable, reliable, and clean sources of energy. Consistent with this view, we have tried to examine the impact of eco-innovation and financial inclusion on renewable energy development in China. In order to empirically investigate, we have applied the autoregressive distributive lag model. The long-run estimates of eco-innovations are statistically significant and positive models, confirming that environmental-related innovations help increase the production of different renewable energy. Similarly, the long-run estimates of financial inclusion are positively significant, implying that an increase in financial inclusiveness intensifies the production of solar, biomass, and renewable energy in China. Generally, our findings imply that both eco-innovations and financial inclusion help increase renewable energy production in China in the long run.

Application of the IoT in the Food Supply Chain─From the Perspective of Carbon Mitigation.

With the rising demands on supply chain transparency and food security, the rapid outspread of the Internet of Things (IoT) to improve logistical efficiency, and the rising penetration of sensor technology into daily life, the extensive integration of the IoT in the food sector is well anticipated. A perspective on potential life cycle trade-offs in regard to the type of integration is necessary. We conduct life cycle assessment (LCA) integrated with shelf life-food loss (SL-FL) models, showing an overall 5-fold leverage on carbon reduction, which is diet dependent and a function of income. Meat presents the highest leverage, 35 ± 11-times, owing to its high carbon footprint. Two-thirds (65%) of global sensors (1 billion) engaged in monitoring fruits and vegetables can mitigate less than 7% of the total reduced carbon emissions. Despite the expected carbon emission reductions, widespread adoption of the IoT faces multiple challenges such as high costs, difficulties in social acceptance, and regional variability in technological development. Furthermore, changes in the distribution of transportation resources and dealer service models, requirements regarding the accuracy of sensor data analysis, efficient and persistent operation of devices, development of agricultural infrastructure, and farmer education and training have all increased uncertainty. Nonetheless, the research trend in smart sensors toward smaller chips and the potential integration of machine learning or blockchain as further steps make it possible to leverage these advantages to facilitate market penetration. These insights facilitate the future optimization of the application of IoT sensors for sustainability.

A Heterogeneity Study of Carbon Emissions Driving Factors in Beijing-Tianjin-Hebei Region, China, Based on PGTWR Model.

The Beijing-Tianjin-Hebei region is an important economic growth pole in China and achieving carbon emission reduction in the region is of great practical significance. Studying the heterogeneity of the influencing factors of carbon emission in this region contributes to formulating targeted regional carbon emission reduction policies. Therefore, this paper adopted thirteen cities as individuals of cross-section and conducted spatial and temporal heterogeneity analysis of the influencing factors of converted carbon emissions in the region with panel data from 2013 to 2018 based on the PGTWR model. From a space-time perspective, the regression coefficient of each influencing factor in this region has obvious heterogeneity, which is mainly reflected in the time dimension. In the study period, the impact of industrial structure, the level of urbanization, energy intensity, and the level of economic growth on carbon emission showed a decline curve, while the impact of the level of opening up and the size of population was on the rise, indicating that more attention should be paid to the latter two factors for the time to come. In terms of space, the differences in the influence of industrial structure and energy intensity on carbon emission vary significantly.

Purpose in Life and Cognition Interact to Impact Healthcare and Financial Decision Making in Old Age.

Objectives: Little is known about the contribution of positive psychological factors, such as purpose in life, to healthcare and financial decision making in aging. Here, we examined the relationship between purpose and decision making and tested the hypothesis that purpose benefits decision making, particularly when cognition is limited. Methods: Participants were 1081 community-based older adults without dementia. Healthcare and financial decision making was measured via a 12-item performance-based instrument. Purpose was measured via a 10-item scale. Results: In a linear regression model adjusted for age, sex, and education, higher global cognition was associated with better performance on the decision making measure, as expected. Purpose was not directly related to decision making. However, the interaction of purpose with cognition was significant, such that greater purpose was associated with better decision making among persons with lower cognition. Discussion: Purpose in life may promote better decision making among older adults with lower cognition.

Financial fragility and scam susceptibility in community dwelling older adults.

We tested the hypothesis that financial fragility is associated with higher scam susceptibility in older adults without dementia. Data came from nearly 900 community-dwelling participants from two ongoing cohort studies of aging. Financial fragility was determined by assessing an individual's ability to access $2,000 within a month for an unexpected expense. Scam susceptibility was assessed via a 5-item instrument that measures perceptions and behaviors that predispose older adults to financial fraud and scams. On average, participants were 82 years of age. Nearly 10% reported financial fragility. Financial fragility was higher in Blacks and among those with fewer years of education, lower income, lower global cognition, lower literacy, and poorer financial decision-making. Regression analysis revealed that financially fragile older adults were more susceptible to scams. These data suggest that targeted efforts to reduce financial fragility and improve literacy and cognitive health are needed to prevent elder exploitation among diverse populations.

Metamemory and financial decision making in older adults without dementia.

OBJECTIVE: Metamemory refers to self-awareness of one's memory function, and the extent to which metamemory deficit impacts financial decision making is unknown. This study tested the hypothesis that metamemory deficit is associated with poor financial decision making among older adults without dementia. METHOD: Data came from 502 community-dwelling older adults participating in the Rush Memory and Aging Project. Metamemory deficit was determined empirically by contrasting subjective memory ratings with performance on objective memory tests. Larger discrepancy of self-rated memory scores from performance-based testing scores indicates greater deficit. Financial decision making was assessed using a performance-based measure. Multivariable regression analyses examined the association of metamemory deficit with financial decision making. RESULTS: Participants had a mean age of 83 years and a mean education of 15 years. Approximately 75% were female. On average, participants answered two thirds of the financial decision making questions correctly. Female sex, older age, lower education, and lower financial literacy were correlated with poorer financial decision making. In an ordinal logistic regression model controlled for demographics and financial literacy, an 1SD increase in metamemory deficit reduced the odds of having better financial decision making by approximately 15%, OR: 0.844, 95% CI [0.719-0.991]. This association persisted after further controlling for family income, early life socioeconomic status, depressive symptoms and executive function. CONCLUSIONS: Metamemory deficit in older adults is a potential indicator of impaired financial decision making. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Assessment of the value of adjuvant radiotherapy for treatment of gastric adenocarcinoma based on pattern of post-surgical progression.

PURPOSE: To assess the value of adjuvant radiotherapy for treatment of gastric adenocarcinoma and to investigate subgroups of patients suitable for adjuvant radiotherapy. METHODS AND MATERIALS: Data from 785 patients with gastric adenocarcinoma who had undergone D1/D2 radical resection and adjuvant chemotherapy were collected, the site of first progression was determined, and the relationship between the rate of local recurrence and clinicopathologic features was analyzed. RESULTS: By the end of the follow-up period, progression was observed in 405 patients. Local recurrence was observed as the first progression in 161 cases. The local recurrence rate was significantly lower than the non-local progression rate (20.5% vs 31.5%, p=0.007). Multivariate Cox regression analysis showed a significant relationship among degree of differentiation, T stage, N stage, and rate of local recurrence. CONCLUSIONS: Not all patients with gastric carcinoma required adjuvant radiotherapy. However, patients with poorly differentiated cancer cells, advanced T stage (T3/T4), and positive lymph nodes, which included patients in the T4N1-2M0 subgroup, were recommended for adjuvant radiotherapy.

Objective Assessment of Daytime Napping and Incident Heart Failure in 1140 Community-Dwelling Older Adults: A Prospective, Observational Cohort Study.

Background Disrupted nighttime sleep has been associated with heart failure (HF). However, the relationship between daytime napping, an important aspect of sleep behavior commonly seen in older adults, and HF remains unclear. We sought to investigate the association of objectively assessed daytime napping and risk of incident HF during follow-up. Methods and Results We studied 1140 older adults (age, 80.7±7.4 [SD] years; female sex, 867 [76.1%]) in the Rush Memory and Aging Project who had no HF at baseline and were followed annually for up to 14 years. Motor activity (ie, actigraphy) was recorded for ≈10 days at baseline. We assessed daytime napping episodes between 9 am and 7 pm objectively from actigraphy using a previously published algorithm for sleep detection. Cox proportional hazards models examined associations of daily napping duration and frequency with incident HF. Eighty-six participants developed incident HF, and the mean onset time was 5.7 years (SD, 3.4; range, 1-14). Participants who napped longer than 44.4 minutes (ie, the median daily napping duration) showed a 1.73-fold higher risk of developing incident HF than participants who napped <44.4 minutes. Consistently, participants who napped >1.7 times/day (ie, the median daily napping frequency) showed a 2.20-fold increase compared with participants who napped <1.7 times/day. These associations persisted after adjustment for covariates, including nighttime sleep, comorbidities, and cardiovascular disease/risk factors. Conclusions Longer and more frequent objective napping predicted elevated future risk of developing incident HF. Future studies are needed to establish underlying mechanisms.